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Eye health – Getting your eyes tested

It is important to get your eyes examined regularly, even if you do not need glasses. A regular eye exam may help to prevent unnecessary sight loss.

Who’s who?

Optometrist or Optician

An optometrist is qualified to examine the eyes and prescribe and supply spectacles and contact lenses. Although commonly referred to as opticians (ophthalmic opticians), the official title in Irish law is now optometrist.

Dispensing optician

A dispensing optician supplies and fits spectacle frames but is not qualified to prescribe lenses.

Ophthalmologist

An ophthalmologist is a medical practitioner specialising in the diagnosis and treatment of eye diseases.

An eye exam is carried out by an optometrist to determine if you require spectacles and what the correct prescription will be. The examination also involves checking to see if the eyes are healthy. An optometrist cannot diagnose disease but he/she is trained to recognise the signs of developing eye conditions and will refer the patient on to the relevant specialist.

Although each eye exam may vary from person to person, an optometrist will follow a certain routine, as outlined below.

Discussion

Your optometrist will discuss any problems you are having, such as headaches or difficulty seeing up close or in the distance. You may also be asked about your family history, as well as your own medical history. Certain conditions may be hereditary, such as glaucoma and diabetes.

Vision

The optometrist will then check your distance vision by seeing how far down the letter chart you can read. This is done first without any spectacles and then with your spectacles, if you have any.

Retinoscopy

This is used to determine the prescription you may need. The optometrist uses a retinoscope to shine a light on the back of the eye (the retina), which shows him/her a red reflection called the retinal reflex. When the optometrist moves the retinoscope, this reflex moves also. The optometrist will put trial lenses in the trial frame in front of the eye until the reflex stops moving.

Subjective test (refraction)

The optometrist will now determine the final strength of the spectacles required. This time you will be asked to read the letters on the chart while the optometrist tests stronger and weaker lenses until you can see best.

Ophthalmoscopy

The optometrist uses the ophthalmoscope to view inside the eye. This instrument has a series of tiny lenses on a revolving rack and by changing these the optometrist can focus on the front of the eye (the cornea) right through to the back (the retina). This part of the exam is a vital health check for the eye. It can reveal conditions such as cataract, glaucoma and retinal detachment.

The eye is the only part of the body where the blood vessels can be seen without surgery. The optometrist can see the arteries and veins in the retina and can therefore detect problems like high blood pressure and diabetes. However, the optometrist is not qualified to diagnose these problems so if he/she detects anything abnormal the patient will be referred to their GP, or directly to a specialist if necessary.

Free eye care

The Health Service Executive (HSE) is obliged to provide optical services free of charge to:

Medical card holders and their dependants;

Pre-school children and national school children referred from child health service and school health service examinations;

People with Hepatitis C who contracted the disease through the use of Human Immunoglobulin-Anti-D or from the receipt within Ireland of any blood product or a blood transfusion and who have a Health Amendment Act Card.

Vision tests and standard prescription spectacles (where required for medical rather than cosmetic reasons) are free of charge to the groups listed above.

Children who are discovered to have sight problems at child health service or school health service examinations are referred to the appropriate consultant for treatment. If this treatment is carried out at the outpatient department of a public hospital, the service is free and no hospital charges have to be paid.

Who is entitled to a medical card?

Anyone over 70 years who is normally resident in Ireland is entitled to a medical card regardless of means. You can get a medical card if you have no income other than:

The Treatment Benefit Scheme is available to insured workers and retired people who have the required number of PRSI contributions. Under the scheme, you get a contribution towards the costs involved. To qualify for Treatment Benefit you must satisfy the PRSI conditions

Treatment Benefit is a scheme run by the Department of Social and Family Affairs that may allow you to qualify for.

This scheme was changed in Budget 2010 and will now be restricted to the medical and surgical appliances scheme, free dental examinations and free eyesight examinations. This means that people who have sufficient PRSI contributions may qualify for a free eye exam only; free spectacles or contact lenses will no longer be available.

For more information on the Treatment Benefit Scheme contact your local Social Welfare Office. Alternatively, you may contact: